| Project/Area Number |
62870051
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| Research Category |
Grant-in-Aid for Developmental Scientific Research
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| Allocation Type | Single-year Grants |
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| Research Field |
General surgery
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| Research Institution | Shiga University of Medical Science School of Medicine |
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Principal Investigator |
KODAMA Masashi Shiga Univ. Surg. Dept. Prof., 医学部, 教授 (50079836)
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| Co-Investigator(Kenkyū-buntansha) |
TANI Thoru Shiga Univ. Surg. Dept. Assis. Prof., 医学部, 助手 (20179823)
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| Project Period (FY) |
1987 – 1989
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| Project Status |
Completed (Fiscal Year 1989)
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| Budget Amount *help |
¥21,600,000 (Direct Cost: ¥21,600,000)
Fiscal Year 1989: ¥2,300,000 (Direct Cost: ¥2,300,000)
Fiscal Year 1988: ¥4,200,000 (Direct Cost: ¥4,200,000)
Fiscal Year 1987: ¥15,100,000 (Direct Cost: ¥15,100,000)
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| Keywords | endotoxin / sepsis / septic shock / Polymyxin B / Direct hemoperfusion / Measurement of endotoxin / cytokine / blood purification / エンドトキシン / 体外血液潅龍 / ポリミキシン / 吸着剤 / 体外循環 |
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| Research Abstract |
1) Evaluation of the capacities of PMX-F and clinical application: Until this Grant, PMX-F was already proofed efficient in circulatory dynamics and survival rate on the endotoxin infused shock models of the dogs and mice. And then this treatment was certified also on the E.coli infused septic shock model of dogs. PMX-F could adsorb endotoxin from water and serum (protein contained solution. Tumor necrosis factor was also adsorbed well.
2) But measurement of endotoxin in the blood was found to be unreliable. All the commercialized measurement kits could not be believed. So we have tried and invent new method and pretreatment of the sample. Now new method is almost archived. By this new method, PMX-F adsorb endotoxin from the blood of patients.
3) After establishments of size and the method of sterilization of PMX-F colomn for human, clinical trial was started under the permission by the Welfare Ministry. And 10 patients with septic shock were treated by this column with DHP. The efficacies and safety of this treatment were certified in the human cases at the least.1 Protocol; Case :septic patients Column:170ml/volume of PMX-F for DHP Flow rate:60 - 200ml/min Anticoagulant:Heparin or Nafamstat mesilate Duration: 2 hours Monitors: glood gases, circulatory dynamic factors(Swan-Gantz) chemical factors of blood, metabolic factors,
4) Mechanism related to the efficacy on septic shock by PMX-F: The reduction of endotoxin in the blood was difficult to certify, because the measurement method of endotoxin could not be believed. New concepts was stressed that the infused endotoxin stayed in the circulating blood so long time than that it was thought to disappear from immediately. And toxic effects of endotoxin also remains. On the other hand the endotoxin detoxifying abilities by plasma was certified but not so much. Endotoxin removal from the blood had the right as an effective treatment for endotoxin shock.
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